Assessment of gait
Introduction
 Defined as translatory progression as a whole produced by coordinated ,
rotatory movement of the body segments
 Gait has been studied the most comprehensively of all human movements
 Wide variety of technology
 Frame by frame analyses
 Knowledge of COP with the help of force platforms
 Electro-goniometers
 Electromyography
Introduction
Winter proposed the following five main tasks for walking gait:
 Maintenance of support of the head , arms, trunk and thus preventing collapse
of the lower limb
 Maintenance of the upright posture and balance of the body
 Control of the foot trajectory to achieve safe ground clearance and a gentle
heel or toe landing
 Generation of the mechanical energy to maintain the forward velocity or to
increase the forward velocity
 Absorption of mechanical energy for shock absorption and stability or to
decrease the forward velocity of the body
Phases of Gait Cycle
Differences in terminologies- stance phase
Differences in terminologies –swing phase
 Initial contact – instance at which the
heel touches the ground (also called
heel contact/ heel strike)
 Foot Flat – first instance at which the
foot is flat on the ground , at around 7%
of the gait cycle
 Mid-stance- - point at which body
weight is directly over the supporting
extremity – at around 30% of the cycle
 Heel off – at about 40 % of the gait cycle
 Toe off – at about 60% of the gait cycle
Swing Phase
 Early swing phase – from the toe leaving the ground till mid-swing, also
called initial swing, or acceleration phase
 Mid-swing – when the leg is passing directly under the body, or from end
of acceleration to beginning of deceleration
 Late swing phase - midswing to just before heel strike, also called the
terminal swing or deceleration phase
Gait terminology
Temporal variables
 Stance Time amount of time spent on one extremity in a gait cycle
 Single support time
 Double support time
 Stride duration
 Step duration
Distance Variables
 Stride length – heel strike to heel strike of same extremity , right and left steps may be unequal due to
biomechanical reasons
 Step length – distance between two successive points of opposite extremities
 Cadence – no of steps per unit time , at around 180 steps per minute the double support phase vanishes
 Walking velocity
 Step width – center of heel to center of heel , mean around 3.5 inches
( 8.5-9 cms)
 Degree of toe out angle formed by each lines foot progression and a line intersecting the center of the heel
and the second toes average 7⁰, toes decreases as the speed of walking increases
Kinematics – Joint Range of motion(Sagittal
Plane)
Sagittal Plane-Internal Moments
Trunk and upper extremities
 Trunk remains essentially erect but
 Flexion tendency around heel strike
 Extension around mid stance
 In the sagittal plane, the pelvis moves up and down in each cycle , lowest point
around the heel strike and highest point around the mid-stance phase
 Frontal plane: pelvis translates from side to side about the same amount
 Transverse plane – looking at the pelvis from above it rotates 4⁰- 8 ⁰ counterclockwise
during swing phase of the right limb, gets in neutral position about midstance, then
left side rotates forward with swing phase
 When the pelvis rotates forward for initial contact, the trunk rotates opposite to keep
the thorax facing forward
Arm swinging
 Opposite to that of leg and pelvis but same as that of trunk
 Right arm swings forward with the left leg swinging forward
 Normally ROM is around 30⁰ (24⁰ extension and 6⁰ of flexion)
Stair Gait
 No major change in ankle moments
 Significant changes in hip and knee
 Concentric/eccentric work
 Clinical implications
Pathological gait
 Three major reasons for abnormal gait:
 Pathology or injury in a specific joint
 Compensation for injury or pathology on same side limb
 Compensation for injury or pathology on the other side
Gait deviations/pathological gait
 Gluteus maximus gait
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Gait deviations/pathological gait
 Antalgic gait
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Gait deviations/pathological gait
 Gluteus medius gait
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Gait deviations/pathological gait
 Drop foot gait/high steppage gait
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Gait deviations/pathological gait
 Quadriceps weakness
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Gait deviations/pathological gait- class
activity -20 minutes
 Learning activity –Table 14.10 .Simulate each type of gait deviation and discuss
the cause of this deviation described in the last column.
 Excessive foot pronation
 Excessive calcaneal eversion
 Insufficient push off
 Foot slap
 Increased base of support (>4 inches/10 cm)
 Circumduction
 Hip hiking
 Excessive trunk lateral flexion (compensated Trendelenburg gait)
 Pelvic drop
 Shorter stance phase on involved side
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